Journal
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
Volume 43, Issue 1, Pages 94-104Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyt233
Keywords
Children; mental distress; asylum seekers; refugees; relocations; longitudinal studies
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Funding
- Netherlands Association for Community Health Services
- Department of Public Health of the University of Amsterdam
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Methods Data were extracted from the electronic medical records database of the Community Health Services for Asylum Seekers in The Netherlands (study period: 1 January 2000-31 December 2008). Included were 8047 children aged 4 to 17 years. Case attribution was done using International Classification of Primary Care codes for mental, behavioural or psychosocial problems. The association between annual relocation rate and incidence of mental distress was measured using relative risks (RR) estimated with multivariate Cox regression models. Results A high annual relocation rate (> 1 relocation/year) was associated with increased incidence of mental distress [RR = 2.70; 95% confidence interval (CI) 2.30-3.17]. The relative risk associated with a high annual relocation rate was larger in children who had experienced violence (RR = 3.87; 95% CI 2.79-5.37) and in children whose mothers had been diagnosed with post-traumatic stress disorder or depression (RR = 3.40; 95% CI 2.50-4.63). Conclusions The risk of mental distress was greater in asylum-seeking children who had undergone a high annual relocation rate. This risk increase was stronger in vulnerable children. These findings contribute to the appeal for policies that minimize the relocation of asylum seekers.
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